Surgical retractors and expanders are used to manipulate a patient's tissues, such as skin, muscle, or bone, and are commonly utilized by surgeons and dentists on the human body and by veterinarians on animals. Retractors have blades that tend to pull the tissue to create more room for a surgeon to view an area of interest, such as a body cavity, and to manipulate other surgical tools. Expanders perform a similar function by tending to push the tissue instead of pulling it. Retractors and expanders are available in a variety of blade sizes and shapes to pull and push different body tissues in different locations on the body. For example, the blade can be curved to lift or separate a portion of the patient's tissues. When both retraction and expansion are needed, a surgeon commonly uses a separate device for each function. This further crowds the patient's body cavity and often requires additional operating assistants to manipulate and hold each device.
While manipulating the patient's tissues, it is important to adequately illuminate the corresponding region of the patient's body. As ambient light is not always sufficient to light a body cavity, illumination is commonly accomplished by a separate light. This light generally must then be held in place near the body cavity by an operating assistant or by some sort of rigging, further crowding the surgical area.
To provide illumination, existing devices may also include a fiber optic bundle to transmit light from a light source to the body cavity of the patient. Such systems, however, also have many drawbacks. For example, the light source often has a limited life and a poor distribution over time. At the end of its life cycle, the light system's components are typically expensive to replace. In addition, the bundle is cumbersome since it often drags on the surgeon and impedes the surgeon's movements. Moreover, the bundle may become de-sterilized due to movement of the surgical staff.
Furthermore, many of the existing devices must be sterilized between uses, a process that may be expensive and time-consuming. Moreover, procedures to sterilize the device may also damage it. Even with sterilization procedures, however, there remains a risk of pathogen cross infection because the instrument will be used more than once. As such, the re-sterilized device will never be as good as new. In addition, there may be other maintenance and extended warranty issues that are not present with a single-use, disposable device.
Existing instruments are also often made of metal. As such, they are difficult to hold for long periods of time since their weight induces fatigue in the surgeon's hands and arms. This is exacerbated by the typical handle design, which is often not ergonomic. Moreover, the metal conducts electricity, which can present an additional risk to the patient and surgeon, such as by electrosurgical burns.
In a typical breast augmentation procedure, for example, a three to six centimeter (3-6 cm) incision is made adjacent the patient's breast. A retractor then holds the tissue up, and an electrocautery tool forms a cavity. An implant is then placed above or below the pectoralis muscle, under the breast tissue.
Existing devices used to perform the breast augmentation procedure include the Accurate Surgical & Scientific Instruments Corporation (ASSI) breast retractor and the Stanger C circular breast retractor (also from ASSI), along with a fiber-optic light source and a suction source. However, the light and suction are only at the end of the device; so light and suction are limited to the end of the device and do not affect the entire breast pocket.
There is therefore a need for a surgical instrument that combines the functions of retraction, expansion, and illumination into a single device while remaining lightweight and easy to handle. There is further a need for such an instrument to be disposable after a single use, yet remain economical. Additionally, there is a need for a light source that illuminates the entire cavity, is cordless, and does not require cumbersome fiber optics. There is also a need for a surgical instrument that provides suction throughout the cavity and is not limited to the end of the device.